Provider Demographics
NPI:1356805766
Name:HENRY, CARON (RN)
Entity type:Individual
Prefix:
First Name:CARON
Middle Name:
Last Name:HENRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4570 CATAMARAN CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1908
Mailing Address - Country:US
Mailing Address - Phone:561-859-8657
Mailing Address - Fax:561-758-4083
Practice Address - Street 1:4570 CATAMARAN CIR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-1908
Practice Address - Country:US
Practice Address - Phone:561-859-8657
Practice Address - Fax:561-758-4083
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9235544163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse